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Soft Tissue Augmentation With Artefill: 10-Year History of Artecoll, Indications, Techniques, and Complications

Published:2010-10-28   Views:2225  From:Peking University Third Hospital

Excerpt:Gottfried Lemperle, MD, PhD,* James J. Romano, MD,† and Mariano Busso, MD‡ *Division of Plastic Surgery, University of California, San Diego, †Private Practice, San Francisco, California, and ...

Gottfried Lemperle, MD, PhD,* James J. Romano, MD, and Mariano Busso, MD

*Division of Plastic Surgery, University of California, San Diego, Private Practice, San Francisco, California, and Department of Dermatology, University of Miami, Miami, Florida

 

To be published in Dermatol. Surg. 2003; 29: June

Most of the biologic filler materials that increase the thickness of the corium in a wrinkle line are phagocytosed within a certain time. Therefore, a lasting effect can be achieved only with nonresorbable synthetic substances. Artefill consists of 20 volume percent microspheres of polymethyl-methacrylate and 80-volume percent of bovine collagen. Beneath the crease, the microspheres with their exceptional surface smoothness stimulate fibroblasts to encapsulate each individual one of the 6-million microspheres contained in 1 mL of Artefill. Collagen is merely a carrier substance that prevents the microspheres from agglomerating during tissue ingrowth. The 20 volume percent of microspheres in Artefill provide the scaffold for the 80% volume of connective tissue deposition, a complete replacement of the injected collagen. The filler material beneath the crease acts as a splint and prevents further folding, thereby allowing the diminished thickness of the corium in the crease to recover. This recovery process is well known even in older patients with facial paralysis and stroke victims, whose facial wrinkles and furrows on the paralyzed side disappear over time.  Since 1994, Artecoll has been used in more than 200,000 patients worldwide (except in the United States) with a low serious complication rate. Because of its higher viscosity and its persistence, injection technique will have a bearing on treatment outcome. A moderate learning curve is likely to be experienced by the physician. Knowing the effect of corticosteroids, however, should enable one to solve potential injection technique results. . Patient satisfaction after Artecoll treatment is over90%; patients usually experience the optimal result after only 3 months when the thickness of the dermis in a wrinkle or fold has recovered.

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